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I just googled "medicare GLP-1 costs", and found this article:

Trump wants Medicare to pay for your Ozempic treatment. Taxpayers may foot the bill for billions in fraud

I am happy to hate Trump because he cuts of GLP-1 for millions. I could probably be persuaded to hate Trump because he wastes billions of dollars on GLP-1 drugs.

Unfortunately, I can not help but notice that both reasons to hate him seem mutually exclusive. While it is nice to know I can hate him no matter what he ends up doing, until he moves out of that superposition of bad options, I am stuck in a state of cognitive dissonance.

The annual US revenue of Novo Nordisk (Semaglutide) seems to be 45G$, while that of McDonalds is 25G$. Likely, NN's profit margin is a bit higher, so they could afford to out-lobby fast food.

--

The question if GLP-1 drugs are a net positive financially for the medical system is extremely cynical. Given that the lifetime patient costs mostly occur in their last years, it basically reduces to of the obese cost more before croaking than the non-obese or not. From a purely financial consideration, the most effective intervention (short of killing them outright) would probably be to offer free base-jumping courses and equipment to medicare patients. The government might spend 10k$ per death caused, which would be a lot cheaper than bypass surgeries, chemotherapy or keeping a dementia patient alive for a decade.

The compassionate, EA-ish metric would be cost per quality adjusted life-year (QALY). Both measles vaccines and doing a full-body MRI scan for tumors once a month are interventions which would boost the QALY of the median patient. But the former is pretty cheap and pretty effective and the latter is very expensive and not very effective, so we pay for one and not for the other.

For GLP-1 agonists, a lot depends on the cost per month.

That fortune article with their moral panic about fraud mentions:

The government recently estimated that covering GLP-1 drugs for obesity would cost Medicare alone $35 billion from 2026 to 2034.

What they forget to mention is that this is peanuts. If half of the patients enrolled with medicare get GLP-1 drugs, that is 35M patients. So the cost per patient per year would be 200$. That is a factor of 60 less than the sticker price of 1000$ a month! If somehow every obese American defrauded the US government into paying 200$ per year for GLP-1 drugs, that would be even better.

I do not think that this is happening, though. I recently turned to biopiracy to knock a few points of my BMI (I will write an article about my experiences on LW at some point), and I will likely spend north of 100$/year on peptides from China. Of course, the medical system will not have patients reconstitute peptides in their kitchen and inject what they think is the correct dose using insulin syringes with no medical or pharmaceutical oversight. Even weekly subcutaneous injections of saline would probably cost 500$ a year.

Interesting, as usual. I almost think we should have a dedicated Saturday Series of Court Opinions: brought to you by ToaKraka™.

I wonder if the dissent with respect to "marriage and child-rearing" is some positioning in case the US Supremes ever revisits Obergefell Re. Roberts dissent:

It (marriage) arose in the nature of things to meet a vital need: ensuring that children are conceived by a mother and father committed to raising them in the stable conditions of a lifelong relationship.

I stood @ToaKraka up the other week on Victoria 3 mods.

While I don't have as many as him, this is what I've been playing with:

  1. Regional HQs are a shitty game mechanic. They absolutely hijack your investment pool, and they're a pain in the ass to remove (made better in 1.9.8) and impossible to remove from Vassals or if they have investments in a third party country. They're also poor game design as they are a "click this button every time if it's available" option, which isn't good game design (good game design is all about making interesting choices).

Thus, I changed AI weights so they never pick them, and I never pick them.

  1. late game performance is awful, because of pop fragmentation. I increased the defines for both assimilation and pop consolidation by a factor of 10x. I think a lot of the background stuff is hard-coded because it really didn't seem to do much. I have a late game save right now that's basically unplayable now (I also fucked up and conquered too much of the world, so multithread performance dropped), so I'm going to try 1000x and see if that helps, I don't think it will.

I did notice that my assimilation did increase dramatically for a while when I had a +25% assimilation buff, so I will test that out eventually (more on this later).

  1. infamy calculation is fucking stupid as it's based off population and not GDP (african states are so expensive it's so stupid). It also scales incredibly poorly in late game. My attempts to rebalance thus far have gone poorly, I can get it to a good place in early game or a good place in late game, but there isn't a good unified set of defines for both I've found yet. I think I could probably add more infamy reduction to later game tech, but my willingness to spend my free time balancing a paradox game for free was low.

  2. clicking "build power plant" a million times makes me want to kill myself. I modded power plants to have 4x output and 4x input. This makes them somewhat overpowered, I don't care, I now click 4x less.

  3. I increased the amount devastation recovers per state. The war goal system is AWFUL which causes AIs to get locked into wars no one can end for a while, which means if one is occupied that whole time it gets inadvertently genocided (population loss has 0 effect on war exhaustion, lmao, and it wouldn't matter if it did, LMAO). Making devastation recover faster mildly helps with this. I think they just fixed this somewhat in 1.9.8, but frankly the AI needs all the buffs it can get in this game.

  4. I changed the law enactment time from 180 days to 50 days. I think this may make the game easier? Although now movements/revolutions are still mad after the law they hate is passed, so I think it's okay. The law passing mechanism is fucking atrocious, and could easily waste YEARS of times bouncing around with "+10%"..."-10%"... etc. This makes it snappy. The challenge of passing a law is maneuvering your political structure into place so it's passable at all. Once you can pass it, it's just a matter of how many de-buffs you take along the way. I'd prefer to pay the cost and move on, not watch a random number generator slowly tick.

Side note, but the paradox communities' acceptance of "save scumming" as an acceptable part of the game, but console commands as "cheating" absolutely sends me. It's literally the same thing, except one is a horrible use of your time. I once (only once) spent 30-45 minutes micro-ing and reloading to pass a very low % law. It was probably the worst use of 30-45 minutes of my free time. I don't understand why people do this in a single player game.

Something I would like to do, is get better at event modding. I want to set up some AI only global events that would trigger in ~early mid game to kick the AI all off traditionalism/serfdom as those laws are crippling and AI sucks at government management.

I also am considering setting up a global event for like +50% assimilation as that seemed to be much more effective than my define tweaks.

I also would like to make a mod that gives the AI +10 goods production of every good in their capital. I think it'll help them bootstrap supply/demand cycles for new goods. I'm not sure how they're doing at electricity production, etc

Finally, I don't know if I can, but I really want to 1) make the AI better at upgrading units as it current SUCKS at doing this and 2) make the AI stop making 30 individual armies, as that provides 0 tactical benefits to the AI, and makes the game noticeably laggier.

EDIT: ONE MORE

migration in this game is in an AWFUL state right now. If you get a Chinese or Indian country in your market, they flood your country at absurd rates (although I do plan to do an India run where I take Canada/Australia and fill em up, for historical accuracy purposes lol).

And mass migrations are basically "human only" because you GDP/capita and SoL maxxxxx and then absorb like 80% of the mass migrations regardless of you're Brazil or Vietnam, which is so fucking stupid.

I need to figure out how to give the new world a massive buff to mass migration attraction.

There's two separate questions in there.

  1. Are they in the Taker class?

  2. Do they perceive and identify themselves as being in the Taker class?

Broke trailer trash generally abhor trailer trash, which they perceive as their neighbors rather than themselves. "I'm poor because I have to support all these people on welfare," "I'm a hard-working man, if I could, and my disability payments would be higher if it weren't for all the immigrants we're supporting..." "I'm just a drinker, he does meth," "I only do a little meth I'm not an addict like that guy over there," "I wouldn't be on the meth if it weren't for trying to compete with illegal immigrants..." There's various degrees of magical thinking involved in excusing one's own temporary circumstances, such as "Rural areas really produce things while urban gdp is fake and gay" or "Once you throw the bums off welfare and the immigrants out, I'll make more money and I won't need Medicaid." I do not think many GOP voters perceive themselves as takers, even if they mathematically are.

I do not think a significant number of Republican voters believe that bad things (for them) will result from Trump's policies and are willing to suffer for them. You can tell because Trump doesn't talk that way, more or less ever. They think that the policies Trump is pursuing will result in the instant improvement of their lives.

On Wednesday evening I went to see Celine Song's new film Materialists, her follow-up to 2023's critically acclaimed and Best Picture-nominated Past Lives, which I adored. The film concerns Lucy Mason (Dakota Johnson) a successful New York-based matchmaker who mostly caters to clients in their thirties and forties. While attending one of her client's weddings, she gets to talking to Harry (played by the omnipresent Pedro Pascal; seriously, he starred in like 1/3 of the movies being screened in that cinema that day), the wealthy brother of the groom whom she attempts to recruit as a client (but he has other ideas). She also runs into John (Chris Evans), an ex-boyfriend and aspiring actor she dumped years prior, and yet who visibly still holds a candle for her.

Right off the bat, let's manage expectations: it's not much like Past Lives, and it's nowhere near as good, but it's still worth a watch.

Past Lives was an intimate, semi-autobiographical character drama about romantic love and Song's own experiences as a Korean immigrant to the West. Here, Song attempts (not entirely successfully) to wed two wholly unlike genres. On the one hand, it's a cold, glassy-eyed and cynical dissection of the economics of modern dating and marriage, in which women marry purely to spite their younger sisters; in which successful career women in their thirties are passed over by their male peers in favour of gorgeous dullards fifteen or twenty years their junior (about whom they have the audacity to complain that they're "immature"); in which Lucy's prospective clients present her with laundry lists of traits their partner must have (no men under 5'11", no women with BMIs over 20). On the other hand, it's a conventional romantic fantasy, in which the female lead has to choose between a wealthy finance bro who's safe but makes her feel nothing, and a starving artist who sends her heart all a-flutter. (No prizes for guessing how she picks.) At times, the dialogue is just as intimate and piercing as anything in Past Lives; at other times, you feel like the characters are reading out choice quotes from /r/femaledatingstrategy. If you've spent enough time in redpill and PUA circles, some of the talking points are sure to inspire a shock of recognition: it's practically a femcel manifesto in cinematic form.

Sadly, Johnson and Evans have very little chemistry with one another. Part of this might just be because of the usual reasons actors don't have chemistry with one another, but I suspect a major contributing factor might be Evans himself. At the time of filming he was a 43-year-old playing a 37-year-old character: looking at his face, I got the distinct impression that he's undergone a lot of Botox and/or cosmetic surgery to maintain a youthful appearance. (No need to do this in his most famous role, for which he mostly wore a mask.) He hasn't gone full Bogdanoff by any means, but whatever procedures he has undergone make it very difficult for him to emote: his skin is simply stretched too tautly across his skull. It was hard for me to believe his character is going through the emotional torpor the screenplay wants me to believe he is when nothing below his cheekbones is conveying this. The fact that men undergoing painful and expensive cosmetic procedures to improve their status in the dating and jobs market is actually a plot point in the film makes me wonder if Evans's casting was intended as some kind of meta-joke.* Johnson's character admits to having had work done on her nose and breasts: I'm dying to know if this is also true of Johnson herself. Nose, perhaps; breasts, probably not.

Johnson and Pascal do have some chemistry with one another, but as my girlfriend pointed out, it's the chemistry you expect between a girl and her gay best friend, or perhaps a girl and her cool uncle. It was hard for me to believe they were romantically interested in one another, even if it's implied that Pascal's character is significantly older than Johnson's (although probably not quite as much as their IRL age gap of ~15 years).

A little funnier than Past Lives, but ultimately it didn't move me nearly as much, even though it was obviously meant to. While watching Past Lives I felt like I was watching real people going about their lives and having genuine conversations, a feeling I never got from Materialists, and I don't think that's just because of the increased star power Song has to work with: a lot of the aforementioned femcel dialogue felt extremely artificial and essayistic. Perhaps the most affecting part of the whole movie is when one of Lucy's clients has been sexually assaulted by a man Lucy set her up on a date with: she angrily throws Lucy's words in her face and tearily insists that she is deserving of love, no matter how much Lucy might urge her to keep her goals realistic. It was a heart-rending scene that has me tearing up a little just thinking about it now. Shame the romantic A-story couldn't inspire anything resembling that kind of raw emotion.

Another data point added to the viewing public's efforts to psychoanalyse Song and her presumably peculiar relationship with her husband, Justin Kuritzkes. Given that both Song's first movie and Kuritzkes's first screenplay (Challengers, directed by Luca Guadagnino) concerned love triangles between a woman and two men, these jokes have been ongoing for some time. Personally, I interpreted Materialists's romantic plot as a spirited defense of Song's decision to marry a sensitive, artsy boy, rather than a wealthy finance bro as her mother presumably wanted her to. At least she had the forethought to marry a successful artsy boy, instead of a loser like John.


*At one point, Lucy and Harry attend a play in which John is starring. A poster for said play mentions that it was written by Celine Song.

That's incredibly fair

The UK's infrastructure seems to be extraordinarily brittle. Three days without rain and they institute a "hosepipe ban."

Please remember that this is not PoliticalCompassMemes; pointing and laughing in the style of Nelson Muntz invites only heat, not light.

While I agree with a lot of what you say, I do wonder if maybe my active/passive definition didn't work.

Catcalling is a specific act, targeted/focused at a specific person. One that is in the overwhelming super-majority of cases is not desired. I would also posit that many a cat-caller does it not just because they think someone is hot, but because they enjoy the fact they get to flex "power" over someone by making them uncomfortable with no recourse against them (dovetails nicely with everyone's discussion about lower class men, they don't get to flex power often).

Having ones ass out is an unfocused act, it is not targeted at anyone. While it may make some uncomfortable, it does so at a much lower rate (and makes people happy at a much higher rate). There is no intent to cause distress.

Finally, while I agree that society is teaching and reinforcing women to be far more paranoid than is warranted, the Venn diagram between "is willing to break social norms by cat calling" and "is willing to go for a cheeky bottom pinch or other form of personal assault" has overlap, there is a small but credible possibility of violence from that person. The Venn diagram of "has ass out in Lululemon" and "will grab your dick through your shorts" is 0, unfortunately.

I'm unconvinced cat calling should be an indictable offense, but comparing it to skimpy clothing is ridiculous.

But does the former class not also vote Republican? Folklore seems to say that they do, and are motivated by a mixture of "willingness to suffer to Do The Right Thing" and spite ("we suffer either way, but at least this way we get to wipe the smug grins off the city-dwellers' faces").

I wish to register doubts concerning the "Europe" headline of some items.

Without knowing anything about your ideas I can only assume that the LLMs, as they are prone to do, have glazed you too much on their value.

Ha, can you imagine if civilization collapses and doesn't rise for another 100,000 years. Then that civilization thinks we were cavemen and finally gets to the moon only to have their heads spin over abandoned flags and moon rovers. Or in another unlikely scenario, we get to Ganymede and find some weird cro magnon trash and porno mags in a pre-fab.

Stuff I'm looking at this week:

Geopolitics

Americas

Court paves way for Trump to yank billions of dollars worth of foreign aid, concluding that aid groups lacked standing to bring the case.

US offers $5m bounty for Haitian warlord 'Barbecue'

Terrible health conditions at Alligator Alcatraz prison

US appeals court says Trump administration can cut billions in foreign aid

Europe

Musk chatbot Grok says it was 'censored' after suspension from X over Gaza posts

Children dying of hunger in Darfur's el-Fasher city

Attempted coup in Mali

Russia Has an Arsenal of New AI Drones Built with Smuggled Nvidia Chips (old news tho)

Zelenskyy: Ukraine won't cede land for peace amid US-Russia summit

European leaders unite behind Ukraine as Trump-Putin meeting nears

Europe says U.S. and Russia cannot decide on Ukraine land swaps at this week's summit

Migrants swim from Morocco to Ceuta as officials say enclave 'overwhelmed'

Middle East

Ireland intends to pass bill to ban the import of good from Israeli settlements despite US pressure

Iran

Where Next for Iran's Supreme Leader? Another review of his unstable grip on power.

Iran arrests 20 Mossad spies, executes nuclear scientist for providing classified information.

WWIII: Palantir CEO Alex Karp Says 3-Front War With Russia, China And Iran 'Very Likely'

Gaza

Israel strike kills Al Jazeera journalists in Gaza due to allegations of his leadership of a Hamas cell involved in rocket attacks.

Benjamin Netanyahu reportedly in talks with South Sudan to take Gazans

Gaza Sees Five Starvation Deaths in 24 Hours

11 more die from malnutrition in Gaza, Hamas-run health ministry says

Israel faces growing global condemnation over its plan to take over Gaza City

Gaza terrorists caught using emblem and vests of the World Central Kitchen.

'It's a horrible picture': Gaza faces new threat from antibiotic-resistant disease

Gaza health system 'catastrophic' with hospitals overwhelmed and medicines running out, WHO warns

Yemen

Yemen's Houthis say they launched 3 drone strikes inside Israel

Asia

Morning Brief: US Coast Guard Commissions First New Icebreaker in Over Two Decades; US, China Trade Accusations Over Panama Canal at UN Security Council

China's Chikungunya Outbreak Surpasses 10,000 Cases, Spreads to Taiwan

Chinese Authorities Mandating Blood Tests, Releasing Lab Mosquitoes to Fight Chikungunya Outbreak (although Epoch Times is not generally a reliable source)

A U.S. destroyer illegally entered the territorial waters of China's Huangyan Island; the Southern Theater Command lawfully and according to regulations warned and expelled it.

On August 13, Navy Colonel He Tiecheng, spokesperson for the Southern Theater Command of the People's Liberation Army, announced the unauthorized entry of the U.S. Navy destroyer "Higgins" into the territorial waters off Huangyan Island. This action was described as a serious violation of China’s sovereignty that undermines regional stability and breaches international law. The Southern Theater Command's naval forces responded by tracking, monitoring, and ultimately expelling the U.S. vessel to assert their legal authority and maintain security in the area.

Key points include the assertion that the U.S. military's activities threaten both China's sovereignty and the peace of the South China Sea. The Chinese naval forces remain vigilant and prepared to defend national interests, emphasizing a continual state of readiness against foreign military actions.

Bangladesh Braces For Potentially Devastating Dengue Outbreak As Cases Surge. The country has documented 101 deaths and over 24,183 infections so far this year

India/Pakistan

Australia To Recognise Palestinian State At UN In September

Germany invites Trump, Zelenskyy, NATO, EU leaders to virtual meeting before Trump-Putin summit

Indian court orders removal of thousands of stray dogs from Delhi region, responding to concerns about rabies. India is facing the highest rabies toll in the world, with approximately 5,700 deaths annually according to government statistics, while some estimates suggest numbers could be as high as 20,000. The stray dog population in Delhi has surged, increasing from 60,000 in 2012 to close to 1 million.

Africa

Over 2,500 cholera cases, 103 deaths recorded in Sudan's North Darfur

Nigeria Emerging As Hub For 22 Islamic Terror Groups

40 dead in Darfur as worst cholera outbreak hits Sudan

FYI there was a pretty terrible famine in Darfur in 1998

US approves potential $346 million weapons sale to Nigeria to bolster security

US imposes sanctions on Congo armed group, mining firms over illicit minerals

Tech and AI

OpenAI gold at the IOI

Just curious where you are reading that? The NC Newsline article doesn't say that:

"The Governor has been clear since March that the General Assembly needs to fully fund the Medicaid rebase, and he recently reiterated his concern when their Band-Aid budget fell $319 million short of what is needed to fund North Carolinians’ health care,” the spokesperson wrote.

The NC Governor doesn't have much power because the NC legislature has a veto-proof Republican majority so I don't really see how you could lay this at his feet.

Edit: Oh, actually they aren't technically veto-proof anymore by the margin of one seat. One or two Democrat representatives have also been voting in step with the Republicans to override governor's vetos.

I'm not addressing every single person who holds a position. People think things for many reasons!

Surely you can recognize that there exist some anti-immigration individuals who would not care if the GDP went up if it meant the Great Replacement occurred.

Pakistan, Afghanistan and Bangladesh are inherently worse than India despite the only major difference being lack of Hinduism and castes.

India needed castes to create smarter outliers at the cost of dumber underclass which is a better deal than Bangladesh.

The world has natural order which wants the blue blooded to be with the blue blooded, the son also rises as they say. Why are castes bad? Do you prefer a slightly higher median with a way fewer smart people. Castes are religious but I'll only defend the sociological factors here.

This is simply untrue, these exams are the reason why French revolution happened and also why you see Asians represented disproportionately in places as their society lives and dies by exam conferred status. Did China or Korea produce anything resembling what Indo Europeans did until the 21st century?

We know aryans had varna, that euros pre Christianity had varna. The cream was skimmed but sometime in the medieval era, free labor from the underclass led to modern demographic issues.

Speaking as an anti immigrant person, I’m concerned we let in people who are ill suited for our culture and who aren’t the brightest. I don’t think the brazilificarion of our nation will lead to economic growth per capita even if it might increase overall gdp; I think it will per capita make it worse.

Insufficient resolution in your maps. The rural Republican counties that are pointed to as examples of Republicans voting against their economic self interest don't consist of 100% Medicaid users, they consist of a class of Medicaid users and a class of non-Medicaid users.

The latter class votes Republican because they hate the former class and want them thrown off Medicaid. This isn't poor people voting to throw themselves off Medicaid, it's contractors voting to throw addicts off of welfare.

Empathy and charity are easier at a distance. Racial Diversity is correlated with racist attitudes in the general public; this is equally true of economic diversity.

I mean exactly. It’s not a serious thing, at least not in the sense that they literally believe in theNeo-Hitler theory. If they did, and they wanted to stop it, they’d be doing that. I find it rather fascinating just from the psychological aspect as it almost seems like a rape fetish, but political. They want to be brutally repressed. They want the camps. They want the mass arrests. It’s exciting to them. That’s why they’re always speculating about canceling elections, martial law, and camps. Not because they believe it’s going to happen (in fact Trump would be stupid to cancel elections or declare martial law because it would create a huge backlash from the general public), but because they want to play out their vision of themselves as plucky rebels defying their Hitler. But because it’s a fantasy and they at least unconsciously understand that, they aren’t willing to accept loses of their lifestyle. They aren’t willing to be arrested, risk their job, make their kid miss practice, break the law, etc. they want to appear to have resisted without the messy stuff.

GPT-5 is really dumb and basically unusable.

I asked it to write me a yt-dlp command to save all my liked videos into a text file. And it just couldn't do it. For whatever reason, it couldn't write a simple, one-line command. It began creating multiple overcomplicated batch files and calling functions that don't even exist.

For context, this functionality is already built into yt-dlp. Earlier ChatGPT versions, also with "thinking" turned on (!), all worked flawlessly.

I had to resort to Claude, which I previously avoided, but which, this time, instantly gave me the correct answer:

yt-dlp -v --cookies-from-browser firefox --flat-playlist --print "%(url)s" "https://youtube.com/playlist?list=LL" > liked_videos_urls.txt

The same exact thing happened when I tried asking it to compress a PDF using ghostscript and also with basic video manipulation with ffmpeg.

It just went on these unrelated rants with hallucinated commands.

Pretty much and that people who like Hinduism can't thank it without an asterisk since modern India has a bad image due to dysgenics.

I get what you mean, you could have messaged this exact thing, though I won't take offence since you mean well. I'm doing better and themotte is my only culture war outlet as I'm usually offline.

Brahmins supported the usurpation of feudal kingdoms to extract more power as they believed that exams and a democratic regime would favor them, it made us powerless and them homeless where the highest Tamil Brahmin can ever be is an employee and not a divine saint the way they could before. Iq is an important factor but not the most important, you can ce exams and have some outlier geniuses but that's not enough to have a functional sovereign society.

Yes, the focus is on saving what can be saved, though I'd much rather support a neo pagan than a Muslim Indian.